CERTIFICATE OF LIABILITY INSURANCE (3)
DATE (MM/DDNY)
2/07/07
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE ' CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ACORD...
CERTIFICA T"fOF LIABILITY INSURArf'lE
"""
PRODUCER
727-796-6666
Wells Fargo Insurance Services
Southeast, Inc.
P.O. Box 31666
Tampa, FL 33631-3666
Alexandra of Clearwater Beach,
Inc. dba Pier 60 Concessions
POBox 3337
Clearwater FL 33767
COVERAGES
INSURED
INSURERS AFFORDING COVERAGE
ASSOCIATED INDEMNITY CORP
National Surety Corporation
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~;~ TYPE OF INSURANCE POLICY NUMBER ~<<i~~rM~~~~ P81t.f~Y,~JJ~JJ~~ LIMITS
A ~ERAL LIABILITY BIND598656
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE W OCCUR
2/1 5/07
2/15/08
-
-
~'L AGGRE~ LIMIT AP~ PER:
I POLICY I I ~~RT I I LOC
A ~OMOBILE LIABILITY
f-- ANY AUTO
f-- ALL OvVNEDAUTOS
SCHEDULED AUTOS
, >---1, ,
~ HIRED AUTOS
~ NON-OWNED AUTOS
BIND598656
2/15/07
2/15/08
>---
. '.
GARAGE LIABILITY
RANY AUTO ,
B EXCESS LIABILITY
tx:l OCCUR . 0 CLAIMS MADE
~ DEDUCTIBLE 0
I RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS'lIABIUTV
EACH OCCURRENCE $ 1000000
FIRE DAMAGE (Anyone firel $ 100000
MED EXP (A.fty one person) $ 5000
PERSONAL" ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
PRODUCTS - COMP/OP AGG $ 2000000
COMBINED SINGLE LIMIT $ 1000000
(Ea accident)
..'
BODIL YINJUI'lY $
(Per person)
0" . . ..
BODILY INJLWlY $
IPer accident) ..
PROPERTY DAMAGE $
IPer accident)
AUTO ONLY - EA ACCIDENT $
OTHER THAN
AUTO ONL Y~
EA ACC $
AGG $
2/1 5/07
2115/08 .. EACH OCCURRENCE
AGGREGATE
1000000
1000000
BIND598658
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECiAl PROVISIONS
RE: 10 PIER 60 DRIVE, CLEARWATER BEACH, FL 33767
RENTAL OF BEACH UMBRELLAS, CHAIRS & FOOTSTOOLS.
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDITIONAL INSURED
AS RESPECTS GENERAL LIABILITY COVERAGE. FAX 462-6957
FLA STATUTE MANDATES 10 DAYS NOTICE OF CANC. FOR NONPAY OF PREMIUM
CERTIFICATE HOLDER I X I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION
$
$
$
$
$
. .'
,
I~S..S!~TU- I TOTH-
Tul'lY uMIT" I I ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES IIIE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEA"OR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINIII UPON THE INSURER, ITS AGENTS OR
REPRES~TI~ES. ^ /'\
AUTr~JJ-.
CITY OF CLEARWATER
25 CAUSEWAY BLVD.
CLEARWATER, FL 33767
I
ACORD 25-S (7/97)
47- 71
lEt ACORD CORPORATION 1988